patient vital signs monitoring via android application

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2015 International Conference on Advances in Biomedical Engineering ICABME)

Patient Vital Signs Monitoring via Android Application

Roy ABI ZEID DAOU

Lebanese German University,

Public Health Faculty,

Jounieh, Lebanon

Enlail: [email protected]

Ali HAYEK, JosefBORCSOK

Department of Computer

Architecture and

System Programming, University

of Kassel

Kassel, Germany

d iff er en t p ara m ete rs c on tro lla ble b y th e m e dic al d oc to r H ea rt

R a t e , SP02, N I B P , EeG, te m pe ra tu re a nd re sp ir atio n r ate ),

g en eratin g a da ily rep ort, a na ly zin g re sults an d n otify in g th e

c on ce rn ed p ar tie s w h en a q ue stio na ble s it ua tio n is r ec og niz ed .

A dd ed to tha t, th e m ed ica l do ctor can set fo r a n ap pointm ent o r

p re sc rib e a m e dic atio n to th e p ati en t. A n oth er im p or ta nt f ea tu re

o f th is sy stem is th at it e na bles th e co n n ection o f m ultip le

p atie nt s th at a re m o nito re d b y th e s am e h ea lth p ro fe ss io na l.

Elias AAD, Farid NAKHLE

Abstract This paper presents a system that is able to monitor

the patient vital signs (Heart Rate, SPO , NIBP, ECG,

temperature and respiration rate) and send them continuously to

the doctor s android phone device. The system enables multiple

patients to be connected to the same doctor. Within the system,

the health care professional may activate/deactivate any of the

vital signs sensors. He can also set a prescription for the patient,

schedule a meeting,... When bad activities are received, a

message is directly sent to the doctor and to the patient relatives

in order to alert them. Note that the Bluetooth connection is used

to send/receive data between the patient platform and its android

system. The tested results showed an almost errol free system

with an accuracy above 950/0 and a few milliseconds delay

between the vital signs reading and their upload over the server.

Keywords= tetemedicine: vital signs; btuetootn connection; real

time monitoring

I. INTRODUCTION

N ow ad ay s, telem ed ic ine is o n e o f th e m ost in cre asin g

te ch no lo gy a pp lic atio n a pp lie d to m e dic al f ie ld b ec au se o f th e

co st re du c tion it m ay o ffer an d th e fu ll m on ito ring ab ility it

insu res [1 ] [2 ]. E ve n th ou g h it w as lau n ch ed b y N AS A in th e

m id 60 s o f th e p re v iou s cen tu ry , th e im prov e m e n t in th is

d om a in r em a in ed s lo w u ntil th e s ta rt o f th e c ur re nt century,

W ith th e d ev elo p m en t of h ig h ly so p histic ated a nd fast

co m mun ic atio n to o ls, th e rea l-tim e m onito rin g b eca m e

acce ssib le an d th e d ev elo ped c oun tries fo un d a w ay , by usin g

telem edic in e, to red u ce th e h u g e b ills th ey m ust p ay fo r th e

h ealth sector [3 ]. H ow ev er, su ch system is still n ot p op ular in

u nd erd ev elo ped co un try as the re qu ired in frastru ctu re is n ot

re ad y to h an dle it [4 ].

T h e a pp lic atio ns in te le m ed ic in e a re d iv er se a nd g o f r0 11 1a

sim ple m ed ical d ata tran sm issio n a n d p roc essin g be tw ee n a

p atien t an d a h ea lth care p ro fessio nal to h igh ly so ph isticate d

de vices u sed in surg eries a s th e D aV in ci R ob ot [5] [6 ]. In fa ct,

te le m ed ic in e u su ally t ak es c on tr ol o f th e r eh ab ilita tio n p ro ce ss

an d en ab le s th e d o cto r o r th e m ed ica l staff to m on ito r th e

p atie nt h ea lth re m ote ly w ith ou t its p hy sic al p re se nc e. H en ce , a

re al-tim e tran sm issio n is n eed e d w ith a m in im al d elay tim e

b etw een sign al cap tu rin g from th e p atien t sid e an d the sig nal

p ro ce ss in g f ro m th e h ea lth c ar e p r of es sio na l s id e.

H en ce, th e p rop o sed w ork p rese nts a n o ve l ap p lica tio n

allo win g a do ctor to m onitor h is p atien t s h ealth a nytim e an d

an yw here v ia a co mm un ica tio n p ro to co l e na bling a real tim e

ex ch an g e of d ata o f the p atie n t s m ain v ita l sig n s. A s fo r th e

spe cificatio ns o f the sy stem , it allo ws th e m ea surem en t o f six

978-1-4673-6516-1/15/ 31.00 2015 IEEE

W he ne ve r m isco n d uc t is read fro m o n e o f th e se nso r, th e

p ro p o sed syste m sen d s a d irect n o tificatio n to th e m edic al

d o cto r an d to the p atien t s rela tiv es in ord er to alarm th em o f

i ts c r it ic a l c o n di ti on .

H en ce , th is p ap er w ill b e d iv id ed a s fo llo w : in s ec tio n 2 , t he

h ardw are sy stem w ill b e p resen ted . T he sen so rs d ep lo yed fo r

th e m ea surem en t o f th e six v ital sig ns are p ro po sed . In sec tio n

3 , th e so ftw are p art as w ell as th e co mm unic atio n to ols fo r da ta

tran sm issio n a re in tro d u ced . S ec tio n 4 sho w s th e w h o le

assem bled sy stem an d som e sce na rio s o f its u se. A t th e en d ,

sec tion 5 prese nts th e co n clu sio n o f th is w ork a nd p ro p o ses

s om e f utu re w o rk s.

II. HARD\VARECONFIGURATION

F ou r sen so rs w ere im plem ente d in o rd er to m easu re th e

p atie nt s v ital sig n s. T h e sen sors a re co n tro lle d b y a b o ard,

w h ic h is eq uipp ed b y a B lu eto o th m o d u le an d a seria l

co m m unicatio n in terface [7 ]. F ig u re 1 rep resen ts the b lo ck

d ia gra m o f th e w h ole s ys te m .

c L ~ 1--: 1:---......._

\-~------4

0- -

STM32f103

Figure Block diagram of the hardware system from the patient side

166


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2015 International Conference on Advances in Biomedical Engineering ICABME

From this system, one can notice the presence of the

STTM32FI03 processor as well as the following sensors:

Temperature sensor ranging from 20C to 45C;

Pulse Oximetry (Sp02) ranging from 35 to 100 ;

5 lead ECG with a voltage ranging between O.SlnV and

5nlVwith up to 4000 samples/second/channel;

NIBP with a measurement range of 30mmHg-255nunHg

for the systolic blood pressure and ISnunHg-220nunHg

for the diastolic blood pressure;

These sensors perform the following additional

measurements:

Heart rate measurement ranging froIn 20 to 300 BPM from

the ECG and the SP02 sensors;

Respiratory wave that uses the chest impedance

measurement method from the ECG sensor with a

sampling range reaching 100 SPM;

Added to that, a power supply and a Bluetooth connection

are embedded on this board. The latter part will be developed

Added to that, a power supply and a Bluetooth connection

are embedded on this board. The latter part will be developed

in more details in section 3.

As for the signals processing and amplification, different

filters were used, mainly for the ECG [8] [9] [10].

As

the

module could be connected to the power line, a notch filter

was a must. This notch filter was responsible to eliminate the

noise generated by the sector line. In addition, the band pass

filter was implemented in order to eliminate all frequencies

lower than 0.5Hz or greater than 150Hz.

Concerning the implementation of these filters, it can be

done by software or by hardware. A hardware implementation

may give better results but needs more time and costs more

money. However, we have chosen to implement the notch

filter along with a pre-amplification stage physical whereas for

the band pass filter, the muscles movement noise and the

second amplification stage, they are implemented within the

code.

III SOFTvVAREAND COM1vftJNICATION TOOLS

This section will be divided into two parts: in the first

one, the software running and handling all electrical/electronic

sensors is presented whereas the second part deals with the

co mm unication too ls needs in order to keep the docto r updated

with the evolution of his patients health.

Software implementation

The first part shows the connectivity hierarchy of this

system. Once the data, COIningfrom any of the connected

sensors, is captured by the processor, it is sent, via the

Bluetooth connector, to the patient device. is then sent to a

se rve r

that is accessible by the doctor. Figure 2 shows the

block diagram of the connectivity hierarchy consisting of the

patient, the health care professional and the patient s relative.

Note that this latter is found in this block diagram because an

automatic message is generated when a mal-functionality is

found in at least one of the patients vital signs.

:

STMJ2f103

Figure

2 -

Block diagram of the connectivity hierarchy

B Communication tools

B Communication tools

As for the c o m m u n i c a t i o n two modes are allowed: the

wireless communication via Bluetooth and the serial wired

communication. The first module will be the primary

communication method. Thus, it is mostly used as the data

will be sent wirelessly to the patient mobile device before

being transferred to the cloud.

Different tools are used for the control of the data

transmission. Once the Bluetooth is connected, the mobile

application asks for the login credentials of the patient. Based

on the patient s identity, already stored on the se rve r the

application fetches the appropriate information and commands

related to it from the remote se rve r These information and

commands are pre-configured by the doctor from his special

control backend installed on his phone. Once this procedure is

completed, selected modules will be enabled or disabled

accordingly by sending the corresponding control orders to the

b o a r d

In fact, the sensors will keep monitoring their specific

parameters. However, only the required vital signs requested

by the doctor meprocessed by the application and sent to the

server. is up to the processor of the board responding to the

commands received to select the data to be sent. During the

program ming and in order to lim it congestion on ly the

required data by the doctor is sent from the patient side to the

se rve r

However, if the doctor doesn t specify any data, all six

vital signs are sent to the server and they are directly

accessible by the doctor. Here, we must note that the data

transmission speed differs from one sensor to the other

depending on the size of the block to be sent and the expected

changes in the vital sign over time.

As the medical professional is the administrator of the

system, he can access the data anytime and anywhere to view

it, enable/disable any of the sensors, set a medication or a

meeting and so on.The doctor can also change the parameters


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configuration or require a new reading. Once a change is

capture from the doctor s side, the board reconfigures the

enabled/disabled sensors, reads all the values and sends the

required ones to the server.

To sum up, figure 3 shows the flowchart containing the

whole process starting from the login authentication till the

data fetching within the server.

lI ,onOt o~ )

A r p I ~

~

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U :tlII~

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r t .d1 ll tJ . .

t

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~dlttlO

..

~/

ril t Ui

I

~

l~ua

l

igure

3-

oftware processing flow chart

Concerning the health care professional backend, a cross

platform application, developed for Android and lOS systems

using PHP, was proposed. TIns program is installed on his

phone and can be accessed from any web browser as well. t

helps to offer full control over the patient s device.

Not only will the doctor be able to add prescriptions and

view appointments, but he will also be able to request an on

demand test for the patient in order to checkup on his current

health status.

Added to that, the data history of eve Y patient will be

saved for easy and fast comparison between its current

conditions and its previous ones. These tests results are saved,

sorted and displayed by date and time. On another hand, up on

patients approval, their data can be donated to universities

and laboratories for medical studies and learning/teaching

purposes.

Figure 4 represents some screen shots of the application

from the medical professional side. In fact, one can notice a

screen shot to choose the patient, another one to read the

values of the tests, a third one for the history, a fourth one

containing the menu and the last one for the login

authentication.

5

igure

4 -

creen shots of the application from the doctor side

IV.

AsSEMBLY TECHNICS

In this fourth part, the diownstream exchange and the

upstream exchange technics will be presented. The

downstream exchange presents the communication from the

cloud to the board via the patient s phone. The incoming and

outgoing information exchanged with the board is partitioned

into packages of hexadecimal bytes specific for each sensor

and parameters required. The commands info packages sent

by the phone to the board using the Bluetooth module are

divided into 2 pruts:

1. A package head set by default to OX5 5 OXAA form ed

by 4 hexadecimal data sets;

2. A Data Package specific for each sensor to be activated

or disabled

formed

by 8 bits. This package struts with

a characterizing bit to select the appropriate sensor

needed.

As for the upstream exchange, it represents the

communication routing starting from the board to reach the

cloud and being accessible by the doctor s phone.

Once all commands are applied, the board responds with

information acquired from the sensors and, as already

described, it sends the data in hexadecimal format but this

time with different length depending on the activated sensor.

The data info packages sent by the board to the phone using

the Bluetooth module can be divided into two parts as follow:

1. A package head set by default to OX55 OXAA form ed by

four hexadecimal data sets;

2. A Data Package specific for each sensor to be activated

or disabled formed by 12 hexadecimal data sets. This

package starts with a characterizing Bit to specify the

parameter sent ECG - NIPB - SP0

2

Temp).


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Figure

5

Top view of the system/rom the patient side

V. CONCLUSION

A fter presenting the proposed system from a hardw are

and softw are points of view , this part w ill list the features of

the proposed system , w ill summarize the w ork done and w ill

p ro po se s ome fu tu re wo rk s.

C oncernin g th e system s features, they can be resum ed as

follow:

Tasks to be done in em ergency;

Capability of monitoring n10re than one patient by a

s ing le doc;

L ig ht w eig ht p orta ble d ev ic e;

S afe ty meas uremen ts;

As for the

summary,

we have proposed a system that

m easures six vital signs of a patient and transm it them to the

doctor via a web

server

that can be accessible anytim e and

anywhere. The main vital signs (Heatt Rate, SP0

2

NlBP,

ECG , temperature and respiration rate) are captured on a

board

carried

by the patient. Signals are being sent to the

server in order to be accessible anytim e/anywhere by the

d oc to r. T he la tte r c an a lso e na ble/d isa ble a ny o f th e se nso rs in

real tim e. The m edical history of the patient is also

stored

on

th e

server

and

alarms

for m edications and further

consu lta tio ns a re ava ila ble optio ns fo r th e sys tem .

Concerning the future works, lot of ideas can be

im plem ented to enrich this

system, As

a start, adding the

c ap ab ility to sto re d ata w hile b ein g o fflin e a nd sy nch ro niz in g

it once the connection is reestablished in no tim e is of m ajor

concern. A nother idea is to im plem ent a video call betw een

the doctor and his patient allowing a live consultation and

d ia gnos tic o f th e

observed

a bnorma litie s. In a dd itio n, a lower

power consumption system would be designed allowing a

better

battery

life to

allow

patients engage in longer tim e

outdoor activit ies .

O n another hand, the safety and security aspects m ust be

viewed in more details in order to reduce or to lim it the bad

e ffe cts th at th is sy stem m ay c au se to p atie nts e sp ec ia lly th at it

is co nnected to th em all day long . T hus, som e m ore cond ensed

com ponents m ay be used in order to let the patient feel m ore

comfor tabl e i n i ts movemen ts .

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patient vital signs monitoring via android application

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